NPIMap

Individual provider Active NPI

Geoffrey Eric Johnson, MD

  • Radiation Oncology Physician
  • Pueblo, CO
National Provider Identifier
1093985251
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
DR 46368 Issued in CO
Practice address
1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone
(719) 557-5460
NPI assigned
Mar 4, 2008
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X DR 46368 CO Primary

Addresses

Primary practice location

1008 Minnequa Ave
Pueblo, CO 81004-3733

Mailing address

1008 Minnequa Ave
Pueblo, CO 81004-3733
Phone (719) 557-5460

Other practice location 1

120 Old Laramie Trl
Lafayette, CO 80026-7012
Phone (720) 457-8383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080818000169 CO Practitioner - Radiation Oncology 5799850335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Loyola University of Chicago, Stritch School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Urology PLLCGroup PAC ID 2365346558, 58 clinicians

Practice addresses (Care Compare)

120 Old Laramie TRL
Lafayette, CO 80026-7012
Phone (303) 695-6106

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR 46368COMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Urology, PLLC CurrentSince Apr 1, 2025 Accepting new patients
Advanced Urology, PLLC Current Accepting new patients
Advanced Urology, PLLC CurrentSince Apr 1, 2025 Accepting new patients
Advanced Urology, PLLC Past Accepting new patients

Locations

4743 Arapahoe Ave
Ste 104
Boulder, CO 80303
Phone (303) 443-4200

32135 Castle Ct
Ste 101
Evergreen, CO 80439
Phone (303) 679-8500

5275 Dtc Pkwy
Greenwood Village, CO 80111
Phone (303) 570-2760

120 Old Laramie Trl
Lafayette, CO 80026
Phone (303) 926-9800

10200 Grand Central Ave
Ste 220
Owings Mills, MD 21117

Interoperability endpoints

  • Direct secure messaging: geoffreyjohnson@tsicua.allscriptsdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 34

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 34

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1093985251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-557-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043733",
            "telephone_number": "719-557-5460"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Old Laramie Trl",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800267012",
            "country_code": "US",
            "telephone_number": "720-457-8383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GEOFFREY",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CO",
            "license": "DR 46368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.